ENDOMETRIOSIS-ASSOCIATED PELVIC PAIN - EVIDENCE FOR AN ASSOCIATION BETWEEN THE STAGE OF DISEASE AND A HISTORY OF CHRONIC PELVIC PAIN

Objective: To track the severity and location of pelvic pain associate d with endometriosis throughout the reproductive-age years and to eval uate the association between these pain parameters and the stage of di sease. Design: Historical prospective study. Setting: Tertiary care ce nter. Patient(s): Forty-eight women with endoscopically staged endomet riosis and chronic pelvic pain who had undergone medical and/or conser vative surgical therapy. Intervention(s): Each participant was adminis tered a questionnaire that included a determination of the severity an d location of her pain. Main Outcome Measure(s): The stage of disease, the area of the pelvis that contained the bulk of disease, the severi ty of pain, and the location of the most severe pain were recorded. Re sult(s): The mean duration from the initial diagnosis until follow-up was 15.7 +/- 3.1 years. Twenty-one (43.8%) subjects denied any symptom s of pain on follow-up evaluation. Of the 27 patients with persistent pain, 21 (78%) identified the location of their most severe pain as be ing the same as at initial diagnosis. The stage of disease at initial diagnosis was significantly associated with a higher degree of pain at follow-up. Conclusion(s): These data suggest that endometriosis-assoc iated chronic pelvic pain commonly persists throughout the reproductiv e years and that endometriosis stage is directly related to the persis tence of pelvic pain. (C) 1997 by American Society for Reproductive Me dicine.